1. Field
The invention relates to the field of automated cytology, and in particular to an interactive system of automated cytology in which a cytotechnologist or cytopathologist interacts with an automated cytology screening system to markedly increase accuracy.
2. Description
Cytotechnologists and cytopathologists are human, and thus subject to human frailties. Among these frailties are drowsiness, inattentiveness, illness, stress, boredom, and fatigue. Moreover, current cytology practice involves a certain amount of subjectivity. By contrast, a computer is devoid of human frailties and totally objective. Accordingly, there has long been sought an automated, computerized system for cytological analysis.
Presently, several computerized cytology systems are being introduced into the market place. Cytyc Corporation has been developing its CDS-1000.TM. cytology workstation in which a computer system identifies cells having the highest potential for being abnormal, representative normal cells for the comparison, and clusters of cells which may be of interest to the system operator. Such a system provides the cytotechnologist or cytopathologist ("cytologist") with a narrowed field of cells for review, but generates no machine interpretation as to specimen normality or abnormality.
NeoPath, Inc. has been developing its AutoPap.TM. 300 system for automatic screening of conventional Papanicolaou slide smears. This automatic analysis system scans multiple smears and classifies each smear either as normal or requiring review. Only samples classified as needing further review are to be reviewed by a cytologist and no cell images are selected for display.
On the other hand, automated computer systems also have their drawback. Although a computer system adds uniformity based on its statistical analysis approach, there is no practical way for the computer to interpret abnormality based on the presence of only a few abnormal cells. Thus, many systems do not rely on the computer to interpret the normality or abnormality of the cells. Neuromedical Systems, Inc. has been developing its Papnet.RTM. system designed with the philosophy that the actual evaluation of the cells and interpretation of the case are left to the cytologist reviewing the case, since the task is both highly complex and subjective. The cytologist reviews each case on a high-resolution, full-color monitor having images displayed in a grid-like manner. Here again there is no computer interpretation of the specific cases.
Moreover, automated cytological specimen classification systems and methods, have been described in U.S. Pat. No. 4,965,725, issued Oct. 23, 1990 to Rutenberg, international publication number WO 91/15826, published Oct. 17, 1991 (claiming priority of U.S. patent application Ser. No. 179,060, filed Apr. 8, 1988, Ser. No. 420,105, filed Oct. 11, 1989, and Ser. No. 425,665, filed Oct. 23, 1989), and international publication number WO 92/13308, published Aug. 6, 1992, and European Patent Publication No. 0 557 871, published Sep. 1. 1993. The contents of each of the above-identified applications, publications and patents, are incorporated herein by reference. Additionally, European Patent Publication No. 0 014 857, published May 2, 1985, describes a method for automatically marking cells and displaying them on a television screen. The contents of this publication are also herein incorporated by reference.
Systems currently under development have sought either to totally automate the cytology system, and thus eliminate the role of the cytologist, or to generate a system merely for preselecting representative cells to be viewed by a cytologist. Until development of the present invention, no attempt has been made to combine cell preselection and cytotechnologist review with an independent machine interpretation, an interactive system in which the cytologist and automated system interact to minimize false negatives, without substantially increasing the occurrence of false positives.